Chapter 18

Print ISBN: 978-93-5547-445-2, eBook ISBN: 978-93-5547-451-3

Effect of COVID-19 on the Mental Health of

Healthcare Workers
Consolata Uzzi a*, Bolaji Yoade b, Victoria Iyanu Olateju c, Mary Olowere d,
Gibson Anugwom e, Mathew Owolabi f, Alexsandra Urhi g, Hafiz Olatunde h,
Fasina Feyikemi i, Oluwafemi Akinbode j, Dolly Ogwu k
and Funso Oladunjoye l

DOI: 10.9734/bpi/idmmr/v2/2275C

ABSTRACT

Background: As COVID-19 pandemic continues to affect every nation, Healthcare Workers (HCW)
who care for the patients are psychologically impacted. The fear of contracting the disease and
bringing it home to their family members, especially aged parents, and those with underlying health
conditions, also makes them susceptible to stress and anxiety. This study aims to assess the
psychological impact experienced by HCW and the psychosocial support they received.
Methods: Using PubMed, google scholar and Embase from December 2019 through June 2021, we
found 376 studies on the impact of the COVID-19 pandemic on the mental health of HCW. Using our
inclusion criteria, 325 studies were excluded. 51 full-text articles were assessed for eligibility. 9
articles which met our criteria and eligibility criteria reported on 19,232 HCW, and 75.2% of the study
participants were women.
Results: The study participants reported high levels of stress, hypervigilance, fatigue, sleep
problems, PTSD symptoms, poor concentration, depression, anxiety, burnout, emotional exhaustion,
depersonalization, suicide and self-harm ideations and somatic symptoms due to the COVID-19
pandemic. The psychosocial support provided to HCW includes counseling and psychotherapy-based
sessions on stress adaptation, onsite mindfulness-based crisis intervention, online form of emotional
freedom technique, and Effort-reward system.
Conclusion: Multiple interventions found in our review were effective in mitigating psychological
stress among HCWs. These interventions should be considered as part of support provided to HCW
with psychosocial challenges.

Keywords: COVID-19; coronavirus; mental health; healthcare workers; depression; anxiety.

1. INTRODUCTION

In December 2019, China announced that it was battling acute respiratory infection thought to have
originated from Wuhan. At the time, very little was known about this new disease called Coronavirus
(COVID 19) and its mode of transmission. As the virus continued to spread from China to different
parts of the world, the World Health Organization (WHO) on January 30, 2020, declared the 2019
_____________________________________________________________________________________________________
a
Columbus Specialty Hospital, 495 N 13th Street Newark, NJ, 07107, USA.
b
Interfaith Medical Center, 1545 Atlantic Ave, Brooklyn NY 11213, USA.
c
Medstar Harbor Hospital, 3001 S. Hanover St, Baltimore, Maryland 21225, USA.
d
Oak Hospital, 191 Lagos Ikorodu Express Road, Agric-ikorodu, Lagos, Nigeria.
e
Houston Behavioral Healthcare Hospital, 2801 Gessner Rd, Houston, Tx 7780, USA.
f
Children’s National Hospital, 111 Michigan Ave NW, Washington, DC 21225, USA.
g
Department of Mental Health, Federal Medical Center, Asaba, Delta State, Nigeria.
h
Jydes Family Clinic, 3550 Milton Pkwy, Alpharetta, GA 30005, Georgia.
i
University of Lagos, College of Medicine, Lagos, Nigeria.
j
American Family Care, 464 Eagle Rock Ave West Orange, NJ 07052, USA.
k
Saint James Medical Center, 5987 Mableton Pkwy SW, Mableton, GA 30126, Georgia.
l
Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas, USA.
*Corresponding author: E-mail: consolata.uzzi@gmail.com;
 Issues and Developments in Medicine and Medical Research Vol. 2
Effect of COVID-19 on the Mental Health of Healthcare Workers

New Coronavirus, a Public Health Emergency of International Concern, and on February 11, 2020,
WHO called it a global pandemic and officially named the new coronavirus - COVID-19 [1,2]. As of
June 2021, the WHO has reported more than 180million people infected with the coronavirus, with
more than 3million deaths recorded [3].
Nonetheless, more people continue to be infected, and the lack of definite treatment has
overwhelmed the health care systems, particularly health care workers. HCWs have assumed critical
responsibilities in the control, prevention, care, and treatment of infected patients during the
pandemic. They provide necessary health interventions for suspected or clinically diagnosed COVID-
19 patients and work on the frontlines, often for long hours under harsh and stressful conditions [4].
The pandemic has led to increased high-quality healthcare demands, increased patient mortality,
emotional and physical stress, and rationing of healthcare supplies. Furthermore, the social distancing
required to prevent the spread of the virus has caused social and psychological distress [5]. HCW
who are working in COVID-19 wards have minimal opportunity to communicate and interact with their
colleagues, which may exacerbate their anxiety and stress [4].
For many HCW, the period of psychological distress attributed to social isolation in the face of limited
medical resources, heavy workload, lack of specific treatments, risk of infection, and the separation
from family and friends for a long time, has created a considerable burden that eventually led to some
mental health challenges such as stress, anxiety, depressive symptoms, insomnia, anger, and fear
[4,6]. The healthcare workers directly involved in the care of patients with COVID-19 are at high risk of
developing psychological distress and other mental health symptoms such as posttraumatic stress
symptoms (PTSS) [7-9].

Similarly, the unexpected nature of the pandemic and the high infectivity of the virus has inevitably
compounded the cause of stress, anxiety, and depression in healthcare workers. Anxiety can be
described as a state of fear and tension in response to a threat [10]. In addition, the fear of contracting
the disease and bringing it home to their family members, especially aged parents, and those with
underlying health conditions, also makes them susceptible to stress and anxiety. These fears and
anxiety indicate the necessity of providing psychological support for healthcare workers, such as
implementing occupational health surveillance programs that train and educate healthcare workers
regarding their ability to address infectious disease and associated psychological distress [5].

COVID-19 is an infectious disease that has affected every nation in the world, creating a worldwide
pandemic. Infectious disease outbreaks have a negative psychological impact on the general
population, and especially on health workers [4]. However, current research mainly focuses on the
general population's wellbeing with little attention being directed toward healthcare workers'
psychological distress. Therefore, the present study aims to assess the mental health symptoms
experienced by healthcare providers and the psychosocial support they received while working in the
frontline of the pandemic and the effectiveness of the support they received.
2. METHODS
2.1 Search Strategy
The systematic review is registered with PROSPERO (registration ID: CRD42021253124). This study
is reported per the protocol reported in the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) statement. We searched PubMed (MEDLINE), Embase and Google
Scholar for articles published between December 2020 and June 2021. String of search terms on the
Medline database are ((coronavirus [MeSH Terms]) OR (covid19[MeSH Terms])) OR (sars virus
[MeSH Terms])) AND (association, mental health [MeSH Terms])) OR (PTSD [MeSH Terms])) OR
(anxiety [MeSH Terms])) OR (acute stress disorder [MeSH Terms])) OR (depression [MeSH Terms]))
AND (healthcare providers [MeSH Terms]). The search terms used for Embase and Google scholar
are, coronavirus, COVID19, SARS virus, anxiety, acute stress disorder, depression and healthcare
providers. All authors initially screened the abstracts of all articles using an abstract screening
software, (abstrackr) and we also searched reference lists of included articles for information relevant
to our study. Studies reporting the effect of the COVID-19 pandemic on HCW mental health were
included.

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2.2 Study Selection

Studies were selected according to the following criteria: population, exposure, comparison, condition
or outcome(s) of interest, study design, and context.
 Population: Healthcare workers.
 Exposure: Healthcare providers actively working at any healthcare institution during the
COVID-19 pandemic.
 Condition or outcome(s) of interest: The primary outcome was the psychological effect of
COVID-19 on HCW. The secondary outcome was to find out if these psychological
stressors/effects influenced the delivery of healthcare.
 Study design and context: Eligible studies were randomized controlled trials, cohort
(prospective or retrospective), case series, and case-control studies.

Inclusion Criteria: Studies examined and reported the psychological effects of the COVID-19
pandemic on healthcare workers, studies involved, articles published between December 1, 2019,
through June 23, 2021, the impact of the COVID-19 pandemic on the delivery of care by health care
personnel, availability of mental health support, and management.

Exclusion Criteria: Literature and systematic review studies, editorials, and commentaries articles
irrelevant to the exposure (COVID-19), and the psychological outcomes, articles not focused on
healthcare professionals.

2.3 Data Collection & Study Assessment

All authors (OA, HO, OF, AU, DO, CU, IO, GA, MO, BY, MO, AO) independently reviewed the
abstracts of all the articles identified. They identified articles to be "Adopted" and "Not Adopted" based
on the inclusion criteria. Afterwards, they screened the adopted articles and created a spreadsheet to
include proposed articles to be used for our research work. This was carefully done with the inclusion
and exclusion criteria. All authors were involved in the final selection process. After the final selection
process, a flow chart table was generated following the PRISMA guidelines. Resources for this review
were obtained via qualitative and quantitative analysis.

2.4 Data Synthesis & Analysis

Quantitative and qualitative studies based on original research examining the impact of the COVID-19
pandemic on the mental health of health care workers were included. The data synthesis was done in
a clear and detailed descriptive summary of the included studies via tabulating. The quantitative data
were extracted using Microsoft Word. All the identified concepts and themes were arranged and
grouped to synthesize significant themes. All authors were responsible for reviewing and discussing
major identified themes in the study. Publication bias was tested by visually inspecting for symmetrical
distribution.

3. RESULTS
Our study included 19,232 healthcare workers from different countries, and 75.2% of the study
participants were women. Among the HCW in the study, 6478 were nurses, 4174 doctors, 4850 public
health workers, 2149 paramedics, and other HCW's make up the other study participants. The HCW's
included in the studies reported experiencing high levels of stress, hypervigilance, fatigue, sleep
problems, PTSD symptoms, poor concentration, depression, anxiety, burnout, emotional exhaustion,
depersonalization, suicide, and self-harm ideations and somatic symptoms due to the COVID-19
pandemic. The most prevailing conditions found in the studies were depression, anxiety, and stress.
Some participants reported that they coped with social support from family, friends, and colleagues
during the pandemic, while others reported that self-resilience and rumination helped them cope.
Some of the articles we analyzed reported specific measures employed to assist HCW in managing
the impact Covid-19 pandemic on their mental health, including- counseling and psychotherapy-based
sessions on stress adaptation, onsite mindfulness-based crisis intervention, online forms of emotional
freedom technique, and emergency reward system.

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Table 1. Study sample characteristics, Effect of pandemic, coping strategies and Mental health assistance provided

Studies Location Type of Study Study Participant Effect of pandemic Coping Mental health Summary of
included characteristics strategies assistance findings
provided
Kris Belgium Original Females- 3858 Stress, Support Suggested RISE The impact of
Vanhaecht et research article Males-645 hypervigilance, from family (Resilience in COVID-19 was most
al. [11]. Unknown- 6 fatigue, difficulty and friends Stressful Events) significant among
sleeping, Anxiety, model participants 30–49
flashback, difficulty years, females, and
Paramedics-1831
concentrating, and nurses. A
Nurses-1508 sad mood. considerable
Doctors- 603 proportion reported
Management- 552 the need for
Others-15 professional
guidance by
psychologists and
more support from
their leadership
Rodriguez- Spain Exploratory Females- 119 Fatigue, Onsite Ninety-two
Vega B. et al. report Males-30 dysregulation of mindfulness- HCWs (61%)
[12] Unknown -1 sleep patterns, based crisis participated in more
Nurses-52 anxiety, depressive intervention than one session.
Nursing assistant- symptoms, and Most study
33, Orderly-11, psychological participants reported
Nursing resident-1, distress. the sessions were
Medical resident-2. helpful. Only three
Physician- 8, people (2%) reported
Cleaning staff-2, a minor adverse
Technician-2, effect (increased
Others-37. anxiety or dizziness).

Mean age of 38.6

years.

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Studies Location Type of Study Study Participant Effect of pandemic Coping Mental health Summary of
included characteristics strategies assistance findings
provided
Berna Dincer Turkey Randomized Nurses caring for stress, anxiety, and Online form of A single online group
et al. [13] controlled trial COVID-19 burnout Emotional EFT session reduced
patients. Freedom stress, anxiety, and
64 females and Techniques burnout levels in
eight males (EFT); nurses treating
Intervention group COVID-19.
Mean age of (n = 35) and a no-
33.45±9.63 years treatment control
group (n = 37).
Han Xiao et China Observational Participants were Anxiety, stress, low Social Levels of social
al. [14] study 51 males and 129 self-efficacy, low support support for medical
females. Of which sleep quality staff were
82 were doctors significantly
and 98 were associated with self-
nurses efficacy and sleep
quality and negatively
related to the degree
of anxiety and stress.
Di Filippo P. et Italy Cross-sectional Fifty-eight Sleep disturbance Lower values of
al. [15] study pediatricians, 55 (67.4%) and anxiety anxiety and social
pediatric residents, (19.4%) support were found in
and 15 pediatric primary care staff
nurses, and 47 compared to
family secondary care one.
pediatricians.

Forty-one were
males, and 134
were females.
Mean age 37.0
years

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Studies Location Type of Study Study Participant Effect of pandemic Coping Mental health Summary of
included characteristics strategies assistance findings
provided
Asghar M.S. Pakistan Cross-sectional All participants Emotional Counseling and Emotional exhaustion
et al. study were physicians; exhaustion (54%), psychotherapy- was observed to be
[16] 47 were females low personal based sessions much greater in
while 40 were accomplishment residents (P = 0.002),
males. (31%) and in those who worked
depersonalization in COVID-19 units (P
18 were (77%) < 0.001), in those
consultants, 43 infected with COVID-
were residents, 19 (P < 0.001), and
and 26 were in those who were
interns unmarried (P =
0.026).
Mean age of 30.87 Depersonalization
± 7.34 years was reported more in
residents (P < 0.001),
in those who worked
in COVID-19 units (P
< 0.001), and in
those infected with
COVID-19 (P <
0.001) regardless of
gender (P = 0.691) or
relationship status (P
= 0.798).
Zhang J. et al China Informed study Public health Anxiety and The emergency The data showed that
[17] workers; 62.89% depression reward system, effort and over-
(3050) were comprising commitment were
females while reasonable work- positively linked with
37.11 (1800) were allocation depression and
males. In addition, mechanism, anxiety, while reward
62.1% were junior, bonuses and was negatively linked
20.1% were honorary titles, a with depression and

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Studies Location Type of Study Study Participant Effect of pandemic Coping Mental health Summary of
included characteristics strategies assistance findings
provided
intermediate, and continuous anxiety.
8% were senior education system,
workers. and better career
development
opportunities
ErenUsul et Turkey Survey article EMS Anxiety Nurses had a
al. professionals: significantly lower
[10] 47.3% (n=190) anxiety level
were females and compared to other
52.7% (n=212) participants (p<0.05).
were males. 51.7% However, anxiety
(n=208) of the among participants
participants were who were concerned
emergency about infecting their
medical family members was
technicians substantially higher.
(EMTs), 27.4%
(n=110) were
paramedics,
12.4% (n=50) were
drivers, 5% (n=20)
were physicians,
and 3.5% (n=14)
were nurses.

The mean age was

33.1±6.9 years.
XuXiaoming et China Cross-sectional Health workers Depression 30.2%, This was an online
al. [18] study anxiety 20.7%, survey of 8817
Doctors- suicide, and safe hospital employees.
3212, harm ideations 6.5% Depression, anxiety,
Nurses- 4685, and somatic somatic symptoms,

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Studies Location Type of Study Study Participant Effect of pandemic Coping Mental health Summary of
included characteristics strategies assistance findings
provided
other HCWs- 920 symptoms 46.2% and SSI (suicide and
self-harm ideation)
Female- 6874 were prevalent in
Male- 1943 30.2 percent, 20.7
percent, 46.2
Mean age of 33.25 percent, and 6.5
± 8.257 percent of this
population,
respectively.

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Fig. 1. PRISMA flowchart

Table 2. Suggested mental health interventions

S/N Interventions Number of Result

participants
1 On-site mindfulness- 150 Participants perceived the intervention as helping
based crisis reduce stress.
intervention [12] There was no significant statistical difference (t =
−0.599, α > 0.05) in the perceived helpfulness
between those participants who attended just one
session and those who attended more than one
session
2 The online form of 80 Highly significant (p<.001) reduction in stress,
Emotional Freedom anxiety, and burnout among the EFT group
Techniques (EFT) [13] compared to the no EFT group.
3 Effort–reward 4850 Reward (OR: 0.91; 95% CI: 0.89, 0.92) had a
imbalance negative association with depression
model(emergency Reward (OR: 0.91; 95% CI: 0.91, 0.94) had a
reward system) [17] negative association with anxiety
4 RISE (Resilience in None The RISE model was initially implemented in John
Stressful Events) (suggested) Hopkins Hospital in 2010 to support HCWs who
8
model experience emotional distress following patient
adverse events. It has so far been demonstrated to
be beneficial to frontline workers in improving
mental health and productivity [19]

3.1 Interventions Implemented to Support Healthcare Workers during the Pandemic

We analyzed the effects of psychosocial interventions implemented to support HCW during the
pandemic. Rodriguez et al. conducted a study on 150 patients. They reported that participants who

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received onsite mindfulness-based crisis intervention sessions perceived the intervention as helping
reduce their stress level [12]. However, there was no significant statistical difference (t = −0.599, α >
0.05) on the intervention effect between participants who attended just one session and those who
attended more than one session [12]. Berner Dinceret al. conducted a study on 80 participants. They
reported that participants who received an online form of Emotional Freedom Techniques (EFT) had a
highly significant (p<.001) reduction in stress, anxiety, and burnout compared to the control group
[13]. Zhang et al.'s study on 4850 HCW also found that the effort-reward imbalance model helped
HCW deal with depression and anxiety during the pandemic [17]. The study reported that the more
the participants were rewarded, the lower their reported depression and anxiety. In addition, a study
by Kris Vanhaecht et al. suggested the need for professional guidance by a psychologist, more
support from healthcare leadership, and implementation of the RISE (Resilience in Stressful Events)
model, which was developed in John Hopkins Hospital in 2010 to provide support to HCW [11].

4. DISCUSSION

Busch et al., in their study, described an intense effect that epidemics and pandemics have on the
mental health of HCW and how this has been consistent over the years [20]. One of the objectives of
this systematic review is to examine if HCW experience mental issues like depression and anxiety
during the COVID-19 pandemic. We observed that depression, anxiety, and stress were the most
prevalent mental health issues reported by HCW. Deng et al. established that anxiety and depression
were seen more in HCW, with the prevalence of 40% and 31%, respectively, instead of the general
population with anxiety and depression at 22% and 26%, respectively [21]. Similarly, Sanghera et al.
reported a higher prevalence of depression (13.5%-44.7%) and anxiety (12.3%- 35.6%) in HCW
compared to the general population [22]. Although lack of social support, pre-existing psychiatric and
medical conditions were suggested to predispose to anxiety and depression in health care workers
during the COVID pandemic, Sanghera et al. substantiated that having direct contact with COVID-19
patients was the most frequently seen predisposing factor [22].

While the COVID-19 pandemic has been associated with mental disorders like anxiety and
depression among health care workers [11,17,18] information on the effect of these disorders on
quality of care is still limited. However, Vanhaecht et al. reported that increased anxiety was related to
exasperated work pressure and heightened work stress, which led to adverse mental health [11].
They further highlighted a probable cause of poor quality of care due to negative mental health. In
general, pandemics and public health crises have been shown to play a significant role in the quality
of patient care. Xiaoming et al. revealed an association between public health outbreak concerns and
15
behavioral changes in healthcare workers primarily attributed to work stress and minimal support .
Unfortunately, this negatively impacts the delivery of care as the healthcare system is burdened
during such a crisis [18].

Furthermore, Lai et al. and Liu et al. reported that depression and anxiety experienced among
healthcare workers during the pandemic caused psychological distress, which indirectly affects the
delivery of care [23,24]. Another study conducted by Lai et al. during the SARS outbreak described
that the probability of nurses developing mental disorders is very high [23]. This translated to a
psychological and physical barrier in the delivery of nursing care.

The anxiety caused by the overburdened system during the pandemic made healthcare providers
more susceptible to emotional, physical, and mental exhaustion which has an inverse relationship with
quality health care, self, and work-efficacy [16]. Even more problematic is the potential of these
mental disorders persisting post-pandemic in affected healthcare providers [16].

The ongoing COVID-19 pandemic revealed loopholes and deficiencies in the healthcare industry.
Multiple studies reported an aggravated negative experience reported by healthcare professionals,
which caused mental disorders like anxiety and depressioion [25,26,27]. Unfortunately, no specific
support system was put in place by most healthcare facilities or hospitals [8]. Some hospitals with
care systems for healthcare professionals suspended operation during the pandemic, placing more
strain on mental health support [8]. It should be noted that multiple studies reiterate the importance of

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protecting healthcare providers' sanity and mental health as this can greatly impact the delivery of
care. The impact could be positive or negative depending on the state of mental health [25,26].

However, some hospitals in China provided mental health support for their workers via telephone
hotlines, group therapy, one on one therapy, and psychotherapy [27,28]. Sadly, very few healthcare
providers utilized these services, most likely due to heavy workload, fear of stigmatization, or limited
break periods [27]. A study by Chen et al. reported a rapid response to prevent and mitigate mental
stress in healthcare providers working at the Second Xiangya Hospital, China [27] A team was put
together to help the staff of the hospital navigate emotional and mental stress. This intervention was
enacted in three ways: a team of psychologists to help providers effectively manage mental stress or
problems, direct access to psychologists via a telephone hotline, and provision of therapeutic group
sessions to help dissolve stress [27]. Unfortunately, again, the hospital staff were not as receptive to
these interventions.

Despite limited mental health assistance during this pandemic, multiple studies have recommended
specific interventions that can help reduce mood disorders and other forms of mental stress. Dewey et
al. suggested creating a very nurturing and safe work environment, reiterating hospital administrators'
support, promoting, and showcasing unity to encourage staff [29]. These factors provide solace and
comfort, creating a healthy work environment. Weiner et al. recommended the implementation of
internet-based or online cognitive behavioral therapy to help mitigate stress in healthcare providers.
Their study showed a significant decrease in stress levels and served as prevention of psychological
distress [28]. Chen et al. reported practical interventions implemented during the pandemic, such as
providing access to clinical psychologists, sufficient personal protective equipment (PPE), a safe and
relaxing space for hospital staff to rest and possibly quarantine [27].

Important findings from our study found the RISE (resilience in stressful event) model proposed by
Kris Vanhaecht et al, a very useful tool in reducing adverse effects of emotional stress experienced by
health workers [11]. This model utilized provision of psychological support as a major tool. The
outcome was improvement in mental health and overall productivity of health workers. Rodriguez et
all implemented the on-site mindfulness-based crisis intervention on front line health workers in their
study and reported a significant reduction in stress for participants [12]. Another study by Dincer et al.
proposed using Emotional Freedom Techniques (EFT), which showed a significant reduction in mood
disorders [13]. A distinct recommendation by Zhang et al. is the use of reward systems; they reported
a risk reduction in the incidence of mental disorders [17].

5. LIMITATIONS

We excluded any articles not published in English and identify that we may have missed articles that
explored this topic in other languages. However, we were able to obtain nine individual studies with a
cumulative sample size of 19,352 which is a sizable number of HCW. Similarly, the included papers
utilized different sampling designs, which could cause some potential biases. Moreover, the studies
used different scales to assess depression and anxiety experienced by HCW during the COVID-19
pandemic, which could cause inconsistencies in the prevalence of anxiety and depression reported by
the studies utilized. Regardless of these limitations, our study was able to substantiate further the
effects of COVID-19 on the mental health of HCW.

6. RECOMMENDATIONS

Most of our studies in this systematic review reiterated the importance of protecting the mental health
of healthcare providers as this can significantly impact the delivery of healthcare. Based on our
findings, specific measures were identified to solving mental health problems among HCW during and
after the COVID-19 pandemic.

 Developing structured therapeutic options for HCW, including but not limited to counseling
and physiotherapy-based sessions, mindfulness-based interventions, online form of emotional
freedom technique, and emergency reward system.

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 Creating a nurturing and safe work environment for HCW is reinforced by the support of
hospital administrators. This will promote unity to encourage staff to continue to contribute
their quota to ending the pandemic.
 Health institutions should create intentional measures that provide a physically safe and
relaxing space for hospital staff to rest and self-isolate from family after learning about their
diagnosis. Thus, providing support for them through the period of their illnesses.
 Focusing financial resources to the most hit communities where wealth equity can spread to
those in need of remunerations, including providing PPEs, drugs, and vaccines, thereby
reducing the incidence of this disease in these communities.

Global efforts in making the mental health of HCW a top priority as much as the attention is given to
the general population to end this pandemic

7. CONCLUSION

Our findings suggest that healthcare workers are at risk of developing mental stressors like anxiety
and depression due to enormous workload and minimal rest during the COVID-19 pandemic. While
most providers attributed their mental stress to fear of infecting family and loved ones, others
highlighted the negative impact of a poor work environment and policies. Our findings also suggest
that limited resources were made available to support healthcare providers during this trying period.
Implementation of the following strategies might help mitigate mental stress, such as a safe and
supportive work environment, online/internet-based cognitive behavioral therapy, judgment-free zone
group therapy sessions, accessible psychotherapy, and emotional freedom techniques

DISCLAIMER

The products used for this research are commonly and predominantly use products in our area of
research and country. There is absolutely no conflict of interest between the authors and producers of
the products because we do not intend to use these products as an avenue for any litigation but for
the advancement of knowledge. Also, the research was not funded by the producing company rather
it was funded by personal efforts of the authors.

CONSENT
As per international standard or university standard, Participants’ written consent has been collected
and preserved by the authors.

ETHICAL APPROVAL

As per international standard or university standard, written ethical approval has been collected and
preserved by the authors.

COMPETING INTERESTS

Authors have declared that no competing interests exist.

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Biography of author(s)

Dr. Consolata Uzzi

Columbus Specialty Hospital, 495 N 13th Street Newark, NJ, 07107, USA.

Consolata Uzzi, MD is originally from Nigeria. She moved to the United States with her family in 1999. She obtained her
bachelor’s degree in biology from Rutgers University in 2006 and went on to obtain her Medical Degree from American
University of Antigua School of Medicine in 2013. Her interest in research began during her undergrad education when she had
the privilege of working as a research assistant with Dr. Wah at the Public Health Research Institute of New Jersey. There she
researched about disease that have plagued Africa such as sleeping sickness, HIV, malaria, and others. The experience was
very rewarding and served as a catalyst to go into more research in public health. Dr. Uzzi has also written other published
articles such as The Impact of COVID-19 on Eating disorders, Risks and Symptoms in the general population. She plans to
continue her passion for research particularly in the areas of public health and mental health. Currently, she is working on her
master’s in public health with a specialization in Global Health. She hopes to one day combine her knowledge of public health
while practicing as a psychiatrist.

Dr. Bolaji Yoade

Interfaith Medical Center, 1545 Atlantic Ave, Brooklyn NY 11213, USA.

She completed her Bachelor of Medicine, Bachelor of Surgery (MBBS) degree from Ladoke Akintola University College of
Health Sciences in Nigeria. She completed her internship in Nigeria and later came to the United States of America and
became ECFMG certified. Currently, she is a research extern at Brooklyn Brain and Mind Institute, Interfaith Medical Center,
Brooklyn, New York, and an MPH (epidemiology concentration) student at Regis College, Massachusetts, USA. She continues
to contribute to the research field and has co-authored publications which include: “On the use of a Modified Kubler-Ross Model
of Grief to Treat Bereavement in Schizophrenia”, “Effect of COVID-19 on the Mental Health of Health Care Workers-A
systematic review” and “The impact of COVID-19 on Eating Disorders, Risks and Symptoms in the general population-A
systematic review”. She is passionate about helping people and serves her community as a volunteer for outreach programs.

Dr. Mary Olowere

Oak Hospital, 191 Lagos Ikorodu Express Road, Agric-ikorodu, Lagos, Nigeria.

She is a Nigerian trained medical doctor who earned her medical degree from the prestigious University of Ibadan in the year
2015, She is passionate about providing compassionate and comprehensive care to patients, particularly those in the
underserved community. Her motivation for research was borne out of a passion to provide clinically proven evidence-based
medicine to her patients, improving the quality of their care. She has been a part of several scholarly papers thus far, including
an abstract and some research publications. She is intrigued by the prospect of broadening her knowledge and offering
solutions to problems, thus laying the groundwork for future studies and publication.

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Effect of COVID-19 on the Mental Health of Healthcare Workers

She is currently employed as a medical officer of health and plans to further her training as a primary care physician. She has a
minimum of 5 years of clinical work experience. She is an ardent believer in setting lofty goals for oneself and maintaining a
positive attitude towards achieving them. She keeps a heart-warming smile always and is fun to be with. She could be seen
writing an article, singing, meditating, hanging out with friends, or going on a trip to see loved ones when not at work.

Dr. Gibson Anugwom

Houston Behavioral Healthcare Hospital, 2801 Gessner Rd, Houston, Tx 7780, USA.

He is a young physician who received his medical education at Danylo Halystsky Lviv National Medical School in Lviv, Ukraine.
After finishing medical school, he moved to the United States of America to pursue his residency training in psychiatry. In
addition to clinical practice and providing excellent patient care, he is very interested in clinical research and teaching and has
made significant contributions to the medical field through numerous cutting-edge research projects. He contributed significantly
to the writing of the abstract and the result section of the main manuscript in the systematic review article, "The Effect of
COVID-19 on the Mental Health of Healthcare Workers," which is published in this book. In addition, he helped with the final
edit and review of the entire manuscript. He has also written several medical books in the past, the most famous of which is
titled "How to Live a Healthy Life and Be Disease Free," to educate high school and college students in the rural communities of
his birth country, Nigeria, how to live a healthy life and avoid common diseases prevalent in rural communities. He intends to
continue contributing to the body of knowledge and psychiatry through research, while also providing his patients with the best
medical care possible.

Dr. Alexsandra Urhi

Department of Mental Health, Federal Medical Center, Asaba, Delta State, Nigeria.

She is a co-author of the research article: “The Impact of COVID-19 on the Mental Health of Healthcare Workers” and
contributed to the writing, editing, and proofreading. She is a medical doctor, currently lives in Nigeria and was born on April
2nd, 1994.

She is a determined and vigorous individual, yet pleasantly calm. She believes in fighting for her dreams and doing it with God,
as, with God, all things are possible.

She was graduated from Delta State University, Abraka, Nigeria in 2018 with a Bachelor’s degree in Medicine and Surgery.
After her degree, she started her intern year at the Federal Medical Center Asaba, Delta state, where her research interest was
ignited after working with senior colleagues who had a great passion for research in publishing her first article: Paediatric
Osteomyelitis in a Tertiary Hospital in South-South Nigeria.

Since then, she has published articles such as the Impact of COVID-19 on Eating Disorders in the General Population, Vaping
and suicidality among adolescents: a possible link, and others, with her interest, focused on mental health as she is very
optimistic about being a psychiatrist.

She is currently serving her country in the Nigeria Youth Service Corps (NYSC) in the Department of Mental Health, Federal
Medical Center, Asaba, Delta state Nigeria. She sees it as a great opportunity to better understand the population with
psychiatric conditions and to also cultivate and nourish her aspiration to be a psychiatrist someday.

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Effect of COVID-19 on the Mental Health of Healthcare Workers

Dr. Fasina Feyikemi

University of Lagos, College of Medicine, Lagos, Nigeria.

She works as a medical intern in Lagos, Nigeria, and she is grateful she is now able to contribute to the profession through
research. She obtained her medical degree at College of Medicine University of Lagos in 2021. She has taken up leaderships
roles at various organizations including Association of medical student university of Lagos (AMSUL) and Arts in Medicine,
Nigeria (AIM). Her love for psychiatry developed during her rotation in psychiatry department in medical school. Since then, she
has been exploring new ways to contribute to the field like being a cofounder of psychiatry enthusiast group (PEnG) here in
Nigeria. She continues to contribute to the research field and has co-authored publications which include “Effect of COVID-19
on the Mental Health of Health Care Workers-A systematic review” and “The impact of COVID-19 on Eating Disorders, Risks
and Symptoms in the general population-A systematic review”. She is passionate about helping people and hopes to serve her
community as a practicing Psychiatrist.

Dr. Oluwafemi Akinbode

American Family Care, 464 Eagle Rock Ave West Orange, NJ 07052, USA.

He earned his Bachelor of Medicine and Surgery (MB.Ch.B) from Obafemi Awolowo University in Nigeria where he assisted
professors in academic research on Infectious diseases. He has over 13 years of clinical experience with proven expertise as a
senior medical officer, supervisory teaching instructor with proficiencies in high-level patient care, health data analysis and
medical research in hospitals. He is currently a safety scientist in a research and development company in United States
focusing on medical review including literature review, and risk management. He has coauthored 2 publications including “The
impact of COVID-19 on eating disorder risks and symptoms in the general population: a systematic review”. He is married with
two children and enjoys traveling.
_________________________________________________________________________________
© Copyright (2022): Author(s). The licensee is the publisher (B P International).

DISCLAIMER
This chapter is an extended version of the article published by the same author(s) in the following journal.
Journal of Advances in Medicine and Medical Research, 33(21): 183-194, 2021.

Reviewers’ Information
(1) Qusay Kh. Al-Dulamey, University of Mosul, Iraq.
(2) Shiv Kumar Mudgal, All India Institute of Medical Sciences, India.
(3) José López Castro, SERGAS, Spain.

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